Field of the Invention
The present invention relates, in general, to improved systems, methods, and devices for monitoring the oral motor kinetics of an infant during nutritive sucking (NS) and non-nutritive sucking (NNS).
Introduction
As the ability of an infant/newborn to feed by mouth safely and efficiently is dependent on the proper development of his/her oral feeding skills, researchers have developed a number of systems for monitoring infant sucking. Sucking is the mechanism used by an infant to feed in order to obtain milk/nutrition. Sucking comprises two components, Suction and Expression. Suction corresponds to the generation of a negative pressure in the oral cavity (intraoral) which draws the liquid into the mouth. Expression corresponds to the generation of a positive pressure when the tongue squeezes the nipple against the hard palate which ejects the liquid into the mouth. The systems for monitoring infant sucking fall into three categories. The first category measures the number of sucks by the number of pressure changes inside the nipple/bottle (1-3). The second monitors only the Suction component of sucking (4, 5). The third system monitors both components of sucking, Suction and Expression (6-9). Suction is defined as the negative intra-oral pressure exerted to draw milk from a bottle or breast into the mouth. Expression, is defined as the compression and/or lengthwise stripping of the nipple (bottle or breast) by the tongue, pushing up against the infant's hard palate to eject milk into the mouth (10, 11).
As the infant's oral motor skills develop, it has been shown that the Expression component appears first, followed by the Suction component (9). Infants using the Expression component alone can feed by mouth safely and successfully, albeit not as efficiently as when using a rhythmic alternation of Suction and Expression (8, 9); the latter being recognized as the full-term sucking pattern (6, 7, 9). These studies demonstrate the physiologic and functional importance of the Expression component of sucking. It has been speculated that compression primarily occurs with immature Expression, while stripping which also includes compression occurs with mature Expression. In brief, studies using monitoring systems that do not include both components of sucking, and in artificial settings, lead to an incomplete understanding of oral motor kinetics and feeding skills. This not only threatens the infants' safety and competence when feeding by mouth, but it also provides an inaccurate knowledge base for the development of oral feeding interventions.